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Related Experiment Videos

[Acute liver failure caused by phenprocoumon -- three case reports].

T Bulang1, J Schönlebe, G Haroske

  • 1Krankenhaus Dresden-Friedrichstadt, III. Medizinische Klinik, Drresden. Bulang-Th@khdf.de

Zeitschrift Fur Gastroenterologie
|September 30, 2004
PubMed
Summary

Phenprocoumon can cause rare but severe liver failure, even after long-term use. Three women experienced jaundice and liver damage, but all eventually recovered without corticosteroids.

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Area of Science:

  • Hepatology
  • Pharmacology
  • Toxicology

Background:

  • Oral anticoagulants, particularly coumarin derivatives like phenprocoumon, are widely prescribed.
  • Drug-induced liver injury (DILI) is a significant clinical concern, with varied etiologies.
  • Phenprocoumon-induced liver failure is an uncommon but serious adverse event.

Observation:

  • Three cases of women presenting with jaundice as the primary symptom of liver failure are described.
  • Liver failure manifested 6 to 18 months after initiating phenprocoumon therapy.
  • No patients received corticosteroid treatment during their illness.

Findings:

  • All three patients experienced a prolonged but ultimately favorable recovery from liver failure.
  • Phenprocoumon should be considered a potential cause of acute liver failure, irrespective of prior drug tolerance.

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  • Fatal outcomes and cases requiring liver transplantation have been documented in similar drug-induced liver injury scenarios.

    • Implications:

    • This case series highlights the importance of considering phenprocoumon in the differential diagnosis of acute liver failure.
    • Clinicians should maintain a high index of suspicion for DILI, even with prolonged drug exposure.
    • If coumarin anticoagulation is essential, careful monitoring of a different congener may be warranted after recovery.